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Treatment Options for Polycythemia Vera

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Polycythemia vera (PV) is a chronic form of non
life-threatening blood cancer. There’s no cure, but that doesn’t mean you
shouldn’t get treatment or don’t have options.

Read about why you shouldn’t delay treating your PV and what
options are available to you.

Purpose of Treatment

The purpose of treatment is to control abnormal cell
replication. This will help reduce the thickness of your blood, allowing you to
get more oxygen. The more oxygen you get, the fewer symptoms you’re likely to
experience.

Another goal of treatment is to reduce complications and
side effects. This includes headaches and itchiness, which are caused by a blockage
of blood flow.

Your hematologist, a specialist in blood diseases, will be the
doctor in charge of your treatment. They will discuss your treatment options,
which will take into account the stage of your disease, your age, your risk of
blood clotting, and your level of tolerance.

When you’re properly treated, you’ll be able to live a
productive life with PV for many years.

Initial Treatment

Treatment typically begins by taking aspirin along with
phlebotomy, a procedure similar to a regular blood donation in which excess
blood is removed and discarded from your body.

Drug Treatment Options

If your PV doesn’t respond well to an aspirin and phlebotomy
regimen, your next option is prescription drugs.

Hydroxyurea is a prescription drug and will likely be the
first course of action after initial treatment. It’s considered a mild form of
chemotherapy. It limits the number of cells made by the bone marrow and is
usually taken if you’re at higher risk than others for blood clots. Some common
side effects of hydroxyurea
include allergic reactions, low blood counts, infection, and others.

Interferon alpha is another drug, and is often prescribed to
younger patients or women who are pregnant. This drug is injected with a needle,
typically three times a week. It will prompt your body to lower your blood cell
counts. One of the main disadvantages of this drug is its expensive price tag.

Jakafi (ruxolitinib) is a newer drug that was approved by
the FDA
in 2014 for those with advanced PV who are unable to tolerate hydroxyurea. As a
JAK2 inhibitor, it stops action of the JAK2 mutation. About 95
percent of those with PV have the JAK2 gene mutation, which causes the
uncontrolled reproduction of cells and the thickening of the blood.

More research is needed to determine the benefits of taking
Jakafi earlier in the course of treatment for PV. Because it blocks the JAK2
gene mutation from signaling the cells to reproduce without control, it may be more
readily used in the future.

Bone Marrow Transplants

One of the last or final treatment options is a bone marrow
transplant. You may consider this option when your PV is advanced and all other
treatments have been ineffective. You may also think about having a transplant
if you experience serious bone marrow scarring and are no longer producing
healthy, functioning blood cells.

After a successful bone marrow transplant, you will no
longer have symptoms of PV. This is because the stem cells, where the disease
originates, will be replaced.

However, complications from a bone marrow transplant can be
serious. This includes rejection of the stem cells by your body and damage to
your organs. Make sure to discuss having a bone marrow transplant thoroughly
with your hematologist beforehand.

Future of PV Treatments

Because there’s no complete cure for PV, advances in
research and treatments are ongoing.

The discovery of the JAK2 gene and its mutation was a huge step
forward in the understanding of PV. A search for the cause of this mutation
continues, and once it’s found, you may see even more advances in treatment
options.

Clinical trials are another way in which new treatments are
being evaluated and tested. Your hematologist may also speak with you about
clinical trials if you’re at higher risk for blood clots.

No
matter what course of treatment you and your hematologist decide is best, know
that PV can be controlled and managed effectively.